Daycare Good for Kids If Mom's Depressed

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Preschoolers with depressed moms who attend group-based child care have a lower risk of developing emotional problems than those who don't, a study found.

Note that receiving care in a group child care setting appeared to moderate the association between maternal depression and child emotional issues, but this protection did not appear to extend to other forms of nonmaternal child care.

Preschoolers with depressed moms who attended group-based daycare have a lower risk of developing emotional problems than those who don't, according to findings from a longitudinal prospective study.

Among young children of mothers with elevated, self-reported depressive symptoms, attending childcare either before 17 months of age (OR 0.24, 95% CI 0.09-0.66, P=0.006) or after age 17 months (OR 0.29, 95% CI 0.11-0.77, P=0.01) was associated with a reduced risk for emotional problems compared with children who remained at home with their mothers, according to Catherine M. Herba, PhD, of the University of Quebec at Montreal, and colleagues.

Preschoolers with depressed moms who never entered child care had about a threefold increased risk for developing emotional problems, compared to children who entered child care before their second birthday (47% versus 17%), they wrote online in JAMA Psychiatry. These children also had more symptoms of societal withdrawal.

"Our findings are consistent with studies showing structured child care to be beneficial for other high-risk children, such as those who live in poverty," Herba told MedPage Today.

The population-based study included 1,759 mothers and children enrolled in the Quebec Longitudinal Study of Child Development. The children were born in 1997 and 1998 and they were selected from birth registries.

The initial study included self-assessment of depression symptoms by mothers when their children were ages 5 months, 17 months, 42 months, and 60 months, using a shortened version of a standardized depression measure (the Epidemiologic Studies Depression Scale). The mothers also reported on child care use at each assessment.

Emotional problems and other internalizing symptoms among the children were assessed yearly by the mothers using a scale developed by study co-author Richard Tremblay, PhD, an emeritus professor of pediatrics, psychiatry and psychology at the University of Montreal.

In contrast to the children with depressed mothers, just 5% to 12% of children with moms consistently reporting few symptoms of depression had emotional problems reported by their mothers.

Receiving care in a group child care setting appeared to moderate the association between maternal depression and child emotional issues, but this protection did not appear to extend to other forms of nonmaternal child care.

Children of mothers with depression symptoms who attended group-based child care had lower odds ratios for emotional problems than those who remained in maternal care (OR 0.21, 95% CI 0.09-0.48, P<.001) or those who were cared for by a relative or babysitter (OR 0.40, 95% CI 0.17-0.94, P<0.05).

"Benefits of regulated group-based child care were greater than those of other types of child care, which could be due to specific features of this type of care, including a more structured setting, care provided by a trained professional, and the child being out of his or her home or being exposed to other children of a similar age," the researchers wrote.

Study limitations included the fact that the mothers reported their own depression symptoms and their children's internalizing symptoms.

Selection bias in favor of less depressed moms being more likely to enroll their children in child care may also have influenced the findings, but the researchers re-analyzed their data using propensity score weights in an effort to address this possible bias, and their results did not change.

"This gives us confidence that we are not simply demonstrating that child care is associated with reduced emotional problems in children of depressed mothers because children who attend child care have less depressed mothers," they wrote.

The study was funded by the Quebec Government's Ministry of Health, the Fonds pour la Recherche en Sante du Quebec, the Fonds Quebecois de la Recherche sur la Societe et la Culture, Canada's Social Science and Humanities Research Council, the Canadian Institutes for Health Research, the Centre de Recherche du Centre Hospitlier Universitaire Sainte-Justine, and the University of Montreal.

Tremblay is the founding scientific director of the Quebec Longitudinal Study of Child Development.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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